Latest / The Health Care for All Podcast / EP8: Intro to HCAO with Pres. Valdez Bravo
Transcript
- Valdez Bravo: when I went to Army Baylor program, it was a fairly conservative school with conservative Army professors But they were... talking about how the US health care system wasn't a system, how it was broken how all these other countries had longer life expectancies, better health outcomes were spending way less, and that our health care system was on track to bankrupt us as a nation by 2030. Rebecca Schoon: to ⁓ have Valdez Bravo join us. ⁓ As I noted, he's president of Health Care for All Oregon's Board. I do have two listener notes before we dive in. ⁓ Number one, you might want to hop over onto YouTube because Valdez is just always bringing the smiles. Valdez walks into a room, he's smiling, he's hugging everybody, he's taking pictures. So if you're having a bummer day, Valdez is the antidote to dark times. Number two, listener note, if you are allergic to puns you might want to tread carefully into this episode because yeah, Valdez is relentless. So with that, Valdez, welcome. And before we delve into the world of HCAO, tell us about your background, what got you into Health care. Valdez Bravo: Well, thank you so much for inviting me to be on the podcast. Rebecca, I appreciate Always to get the word out in all these different ways about Health Care For All Oregon and our work A little bit about me. I'm an Oregon kid. was actually born at OHSU because my mom didn't have health insurance. And for those of you that know OHSU, it's like the public hospital. I can say OHSU hosted my birth. Right from the get go, I've been impacted by these issues. But I grew up in Salem, kind of a blue collar family raised by a single mom who was raised by a single mom. I ended up joining the army for opportunity and to not be a burden on my mom to get out of the house. And when I picked my army job, I just happened to pick medical equipment repair technician. I kind of stumbled into health care by the job that I picked on that computer screen when I went to join the army back in high school. I served in the army for eight years and in army hospitals I was really lucky to serve all around the US and Germany. I was deployed to Afghanistan as part of Operation Enduring Freedom so I was at combat support hospital so it was like MASH ⁓ Rebecca Schoon: Wow. Valdez Bravo: with digital CAT scanners. And I came home and I worked at OHSU. So I kind of come full circle at that point. a little bit like a salmon back to the spawn point. then I switched to the VA. And I took my medical repair skills that the Army had taught me. And I got a job at the VA working on medical equipment and supporting my fellow veterans. And so I was really happy because I was getting to use my Army skills. I'm very mission minded the army really instilled that in me. But then I went back to school at Portland Community College, transferred to PSU, got an English degree with minors in writing and film. And I ended up deciding to pursue a master's in health care administration and MBA. And I was really lucky that the VA had this program called the Graduate Health Administration Training Program where they'd pluck, like high performers from within as part of their executive development program. And they would send you to the Army Baylor program in San Antonio to get a master's in health care administration and an MBA. And it was an awesome, transformative program. They taught me a lot of leadership skills, health systems, health policy, about the US health care, air quote, system. And they'd be the first to do those air quotes. And then I came back home in certain positions of increasing responsibility at the VA. until I took a position as Deputy Director of Operations at the Multnomah County Health Department where I continue to work today. Outside of work, I'm highly involved with Oregon chapter of the American College of Healthcare Executives. And then of course my work with Health Care For All Oregon. The two things that or motivated me in this movement is when I went to Army Baylor program, it was a fairly conservative school with conservative Army professors not everybody, but a lot of them were, and the Baylor program itself, Ken Starr was the chancellor president But they were... talking about how the US health care system wasn't a system, how it was broken how all these other countries had longer life expectancies, better health outcomes were spending way less, and that our health care system was on track to bankrupt us as a nation by 2030. So that was really just interesting for me to hear from my professors, and it was just a key foundation of the theme of our classes. And then the other thing is, a year later I got really inspired by the candidacy of Bernie Sanders, who I'd been kind of following since about 2010. And Bernie was saying, health care is a human right, you know, and everybody deserves health care. ⁓ And it was just interesting that Bernie ⁓ and my conservative Baylor and Army professors were saying a lot of the same things in their criticisms about health care. And so when I came back home and ⁓ did a lot of work on the Bernie campaign, when that subsided, the former president of Health Care For All Oregon, Tom Sincic, who I met through the Bernie movement, ⁓ said he knew that I was really passionate about health care and why don't I come join this scrappy little organization that was fighting to create universal health care in Oregon. And that's when I came on as vice president in 2018. Rebecca Schoon: Well, is quite an arc. ⁓ I love so many things in that story, the conservative. versus liberal politics and how that falls on this issue. It's so interesting because ⁓ in most countries that have universal health care, You have conservative. political parties who absolutely support universal health care. It's really in a US context that we've seen it as this partisan issue, unfortunately. So Valdez Bravo: Right. Rebecca Schoon: ⁓ And I want people to now understand what Health Care For All Oregon is. So how would you describe who we are and what we do? Valdez Bravo: Health Care for All Oregon is a 501c3 nonprofit organization Our core mission is to advocate and educate, raise awareness about the ills of the American health care system and why a universal health care system would be better. At the end of the day, that's what we get up every day and do is advocate for a universal health care system here in Oregon. And we like to say beyond, because we really do feel like a lot of other. innovations in the health care Oregon has led the way and then other states have seen the Oregon way and adopted it. But been around for 25 years, very small, very mighty nonprofit. We're based out of Portland, We have all of one and a half staff, and then two staff to do some contracted work for us. But very small. The rest of it is all people powered, volunteer led, like you and Rebecca, ⁓ on the Board. It's a working Board. The origins of HCAO is interesting. ⁓ Basically, there was an independent petition effort to get universal health care on the ballot back in like 2002, And ⁓ a lot of activists came together in that kind of Margaret Mead fashion of, you know, never underestimated the power of a small group of activists to change the world. So this small group of activists came together, really born out of the labor movement and jobs with justice and their Health care committee, to put this on the ballot. So they came together. They worked to do that. We don't have universal health care yet in Oregon. So obviously, it didn't work. But instead of just packing up their toys and going home and giving up defeated, They stayed together. They kind of used it as like a lighthouse moment, where like the lighthouse brings all the same ships into the harbor. They see each other and kind of tether each other and be stronger as one. And so they did that, and they formed Health Care For All Oregon. I've been president since 2023, got involved in 2018. Our core mission is of like four big things we do. educate, and raise awareness about these issues. Bring more people into the fold and raise more resources by people power and ⁓ soliciting donations to fund the work that we do. Mobilizing that people power And then lastly, ⁓ legislative wins. even though our end goal is universal health care, ⁓ Any kind of legislation that comes up in the annual legislative cycle that de-corporatizes, know, weakens the corporate hold on health care, that strengthens physician relationships with the patient, that gets money out and puts people over profits, ⁓ that's kind of legislation we like and we'll get behind. Rebecca Schoon: Yes, and we have some wins in that area, which I'll ask you about later. ⁓ So you mentioned how ⁓ Health Care for All Oregon has been around 25 years. You've watched this movement grow over time. What's different about where we are now compared to the past? Valdez Bravo: Yeah, we're a lot bigger now. There are a lot more people in this movement and a lot more people know who Health Care For All Oregon is. Now, are we a household name at this point? Not yet, but I'm hoping so. mean, I really, we want to a trusted name on health care issues. And I know that we have that reputation in the legislature. Legislators call us up all the time, you know, about ⁓ the bill that we're working on or other things related to health care. people. have almost 50,000 people in our database who have signed their statement of support that have added their name to hey, I believe we should have universal health care. ⁓ That's usually the starting point, going to our website, hcao.org, signing that statement of support. And then some people become dues paying members and volunteer But it's just a lot bigger. sometimes liken it to being back in the ⁓ 2000s, we were kind of like a fan club of maybe an indie punk band, where it's kind of underground. And not too many people knew about it. But if you knew, you knew. And you were super cool. you'd meet up and talk about how much you love it. ⁓ That's kind of how HCAO was, Really, even up until, I would say, 2016, give a lot of kudos to Tom Sincic, who is really just a get stuff done kind of person, very high energy, very results driven, for really taking us to that next level. Rebecca Schoon: And even in the last. year and a half or two now? Like explosive growth. even when I joined, There was still a kind of scrappy element to it. And now it's incredible to see there's just things happening in corners of the HCAO world that I have no idea what's going on. And before, like I said, we knew everything because it was fairly contained. But it's been so exciting, so inspiring to see. So HCAO is a volunteer-led, donor-supported nonprofit. what does that mean for how the organization operates day-to-day? You mentioned that we have a ⁓ really lean staff and mostly volunteer, but talk a bit about how HCAO is structured Valdez Bravo: good question. Yeah, We're kind of different from your normal nonprofit in that we're not mostly grant or government funded or big, multi-million dollar folks writing us checks because we're getting books into the hands of children or putting food in people's mouths. We're not that kind of service oriented type of nonprofit. Because we are an advocacy awareness nonprofit, the service really that we're providing is empowering people with the education on the issues of our American health care system, how it's broken and why universal health care would be just such a transformational change. We typically like 14 to 16 Board members. But it is a working Board. every Board member is kind of expected to perform some function other than attending our monthly Board meetings, Thank you, Rebecca, for chairing our communications committee. Surprise, surprise. The podcaster is the leading in the communications committee. But we also have a finance and fundraising committee. We have a mobilization committee, We have a legislative committee, That nominations and elections committee, which my friend Wes Brain. a longtime HCAO member would say, is the most important committee, because it's the one that makes sure we put the right people on the bus. so that kind of covers the bases. And then we have a caucus system we have a faith caucus. We have a labor caucus. Like I said, our roots are in the labor movement. So that's like been our strongest caucus And what I'm so excited you alluded to all the new energy that's coming in. It's just kind of like things are exponentially growing. We now are starting a BIPOC caucus. There's a health care workers caucus. An artist caucus, know, so many cool things and it's just all grassroots. So ⁓ we're Rebecca Schoon: Mm-hmm. Valdez Bravo: definitely the type of organization that if you lend your time or your dime, You can of come in here and change things and add things and build it and grow it. And we'd love to hear your ideas and appreciate your support. Rebecca Schoon: And all those committees are open to anyone. So these are not closed groups. If you have background in fundraising, communications, can pop on to any of these meetings, test it out, see if you want to get involved. But also, another core part of our work happens through chapters. So tell Valdez Bravo: Yes. Rebecca Schoon: us about the chapters, Valdez. Valdez Bravo: ⁓ the chapters are all over Oregon. We have at least 14 active chapters right now. But we really do pride ourselves on being Health Care For All Oregon and not Health Care For All Portland. And so we do have a Portland chapter a Washington County chapter and a Clackamas County chapter. But we also have outlying chapters in the Mid Valley Health Care Advocates, which is out in like Linn and Benton County. We have our Lane County chapter. We have our Union County chapter in La Grande. It's one of our most active. You go to Union County meeting, it's going to be a good one. Our Rogue Valley chapter, which is like Josephine, Jackson County down south. We've got a budding Douglas County chapter. Central Oregon chapter. Marion Polk County chapter right there in the heart of my hometown of Salem. We've got a Tillamook chapter. It's small but mighty. There's like, five people, know, but we think it'll grow. gonna do some town halls that way. there's a North Coast chapter too up by a Clatsop County. So if you are listening to this podcast and you're thinking you'd like to get involved, I would say there's three things. And the cool thing is all these meetings there's typically a zoom component. So those committees I was talking about earlier, Those happen once a month, usually, by Zoom. So you can dial in from anywhere. So even if you're not close to one of these places where there's a chapter, anyone can dial into it. Our monthly Board meeting, we meet via Zoom as well. We do a couple of in-person meetings a year, but normally it's Zoom. But the chapter committees do a bit of both. They do meet via Zoom but that's really where you get that that coming together, that in-person connect, the meeting up for the happy hour, sometimes it's in a church, sometimes it's in a pub, sometimes it's in a park, our chapters meet in person, and honestly, Rebecca, one of the things that I hear a lot is of like an added benefit of getting involved trying to make the world a better place There's a lot of people vying for your attention to help do that. Lord knows a lot of improvement that the world needs. But what I hear more and more lately is in this more ⁓ disconnected world where we're always on the phone and ostensibly more connected than ever, you would think, people feel so isolated and lonely. And they really appreciate that they can come out and do some good old grassroots organizing, come together, meet like-minded people with shared values, ⁓ and all working together on something really cool like advocating for universal health care. Rebecca Schoon: And the chapters are on fire. are, they are the ones boots on the ground out in the communities. They're tabling at events. They're going to sports games, handing out flyers. educating people. So this is a great way to pitch in for like the friend group, but also you would be pushing the work forward. This is an issue where information and misinformation are swirling around in a, in a big, messy tangle and so the more information, real data, real stories we can get out there the better. Valdez Bravo: Yeah, totally. we have these little cards. It's like, imagine a simplified, equitable, affordable health care system, a system with no copays, no deductibles, no medical debt, no networks, and a focus on patient care over profit. And then you got the QR code. So just imagine you're outside a Timbers game or your county fairgrounds or at the farmer's market and you're handing these out. It's a great conversation starter. You can put it in one's hand. They can take it home, zap it, learn more about it later. It's really cool. And that was, again, volunteer innovation. Rebecca Schoon: you mentioned this earlier, but this really is an incredible movement where you see ideas originating from the grassroots all the time. Valdez Bravo: It's funny, the advice I got from Tom, my predecessor, when talking to a new volunteer was ask them three questions. Like, sorry. What are you good at? But what do you like to do? Because sometimes those are different. And then how much time do you have? Because somebody could be doing graphic design for their day job, you know? And they're good at that. But is that what they want to do after they just did it for eight hours a day at work? You know, they might want to just simply do some data entry. They might want to make phone calls, or they might want to plan the garden party. if you go to our hcao.org website, there's a volunteer page. There's a whole list of all these different kinds of roles, opportunities to get involved based on different styles of engagement and how people wanted to show up. And I would just say also that A lot of that can also be done virtually as well. it's not like you have to come to the office on Southeast 122nd to do this. Most people don't. Rebecca Schoon: I think I've only been there three times or something. Valdez Bravo: Yeah Rebecca Schoon: So in your view, what's the most important thing that Health Care for All Oregon has accomplished that you think people should know about? Valdez Bravo: So much especially in the past 10 years. when I first got involved we were asking for a a joint task force on universal health care. And so in 2018, that was really the big conversation we had taken some ideas together and working with Senator James Manning out of Lane County, fellow Army veteran, and Michael Dembrow had been like really leading a lot of this work in the Senate and he was getting ready to retire and he said, you know what, ⁓ James, know, Senator to Senator, would you like to take on issue, now that I'm transitioning? And so the handoff was made to Senator Manning ⁓ and I think as he's described it, when you're in the legislature, but you only have so many chips to play. And you can play one on education and one on health care and maybe one on transportation or you have your issues and passions. He put all his chips in on this one issue on health care. And so he was able to pass Senate Bill 770. in the 2019 session, which created a ⁓ task force to go study Oregonians' attitudes on universal health care. Like, what do they think about it? What do they know about it? What would they want out of a universal health care system? And the cool thing about this task force is it wasn't just talking to, like, hospital people academics or, insurance companies. It talked to a wide variety of people both in the health care industry and outside, urban and rural, community members, communities of color. And so I would say HCAO's support and marshaling of folks and excitement and resources And so yeah, so the Joint Task Force of the Universal Health Care came out in September of 2022. was a great diagnostic of Oregonians' attitudes. The second thing I'm really proud of our role in Measure 111. Measure 111 was passed just a few months later in November of 22, thanks to all the Oregonians at the voter ballot box that passed it. And that means that Oregon was the first state in the union, and still the only state, to enshrine health care as a fundamental right in our Constitution. ⁓ And interesting story on that one. Representative Mitch Greenlick, who had that public health background and was just a real health equity champion, would come every year to the legislature with this idea of the HOPE Amendment, helping out people everywhere, I think is what it stood for. But it was basically to do that, to do a constitutional amendment, to put health care as a human right in the Constitution. And every year, you would not get enough votes or signatories or it wouldn't pass. Every year, it wouldn't make it. And sadly, Mitch Greenlick passed following his passing, Representative Rob Nosse from Portland came and he took it up to honor Mitch. the legislature got behind it, and they got it done. And so that's how it got referred to the voters. for that November 2022 vote. so a coalition of members came together, including ONA and SEIU who really led the fight on that. Of course we were there too. And we were so excited in that past because we really did make history by being the first day in union to do that. So what an exciting year that was. So got the Joint Task Force on Universal Health Care in September of 22. Oregon passes, Measure one 111 in November. And then what happened is, all right, we got momentum. So then in 2023, the big push was, here comes Senator James Manning out of Lane County again, playing his chips. And he basically put all his chips in to create a Universal Health Plan Governance Board. So was Senate Bill 1089. And basically, with the charge to create, a Universal Health Plan Governance Board that would basically Take the recommendations of the Joint Task Force and Universal Health Care that had spent three years on the issue. Take everything else. Work with consultants, science, literature reviews. Look around the world and within, and come up with Universal Health Plan And that's the work that's happening right now. last little accomplishment I want to tout, The last thing I would say is really super proud of our role in the Corporate Practice of Medicine doctrine that happened in 2025. Rebecca Schoon: OK. Valdez Bravo: And what happened was one of our Board members, Hayden Rooke-Ley, and if you haven't Googled Hayden Rooke-Ley, he's on fire. He's writing, he's publishing, he started working with then-Representative Ben Bowman ⁓ on a corporate practice in medicine bill. And it, it basically says, ⁓ we've long had a corporate practice in medicine doctrine that said that if you are delivering health care here in Oregon, must be primarily physician-owned, at least 51%. But there were so many loopholes and over the years that the special interests had gotten in where you had private equity groups coming in, buying up the Corvallis Clinic, buying up Oregon Medical Group and all these independent physician-owned practices. And then what happens? Care goes down, physicians leave. In fact, they have to leave because they have these non-compete clauses and stuff. Access goes down, people's outcomes get worse. Hayden's work with Rep. Ben Bowman was to get that done. it really has helped, not completely, but it has really helped slow the private equity folks that have been coming in buying up hospitals and squeeze the profit. Because oftentimes what happens is they buy them up just for the land. And then they close the hospital and sell the land. And then the patients are really screwed. yeah, joint task force to universal health care, measure 111, creating the Universal Health Plan Governance Board. And then CPOM, Corporate Practice of Medicine. Without HCAO being here, I don't think any of those would have happened. Rebecca Schoon: We've been busy and it's great to see it ⁓ coming to fruition. Two notes. Yeah, there was a lot of misunderstanding about the constitutional amendment. I was just on a Reddit thread ⁓ and people were saying, know, it felt so performative. ⁓ What a lot of people don't know is that that was the first stepping stone for a lot of other countries to get to universal health care. Adding it as a constitutional amendment then creates a mandate for the government. their job is to uphold the Constitution to enact it. So the Constitutional Amendment was the pressure piece that. made the legislature then be like, all right, how do we fulfill that promise? And Universal Health Plan Governance Board was the next step. And just a second piece on the corporate practice of medicine, universal health care, the way ⁓ we're proposing it won't fix the entire health care system. We want to manage expectations. ⁓ It'll Valdez Bravo: Yeah. Rebecca Schoon: fix a big old piece, the affordability, accessibility, But that's really on the of the payment side where the bills are going and how the bills are getting paid. There's also this delivery side, how health care is being delivered. ⁓ And there's a lot of issues there with profiteering like you said, this private equity ownership. And I was excited to see Health Care for All Oregon not just stay limited in our financing bubble, ⁓ but that we are looking at the whole system and having a lot of influence in trying to fix the other parts of the health system that are going to continue to need attention and action. So, ⁓ Valdez Bravo: and that was really good advice from Representative Rob Nosse, who chairs the Health and Behavioral Health Committee. He really encourage us to stay committed to our main goal, but to definitely weigh in on those other ⁓ goals along the way. And so that's something we've been doing.